Measuring the complexity of atrial fibrillation electrograms

Journal of Cardiovascular Electrophysiology
Jason NgJeffrey J Goldberger

Abstract

Complex fractionated atrial electrograms (CFAE) have been identified as targets for atrial fibrillation (AF) ablation. Robust automatic algorithms to objectively classify these signals would be useful. The aim of this study was to evaluate Shannon's entropy (ShEn) and the Kolmogorov-Smirnov (K-S) test as a measure of signal complexity and to compare these measures with fractional intervals (FI) in distinguishing CFAE from non-CFAE signals. Electrogram recordings of 5 seconds obtained from multiple atrial sites in 13 patients (11 M, 58 +/- 10 years old) undergoing AF ablation were visually examined by 4 independent reviewers. Electrograms were classified as CFAE if they met Nademanee criteria. Agreement of 3 or more reviewers was considered consensus and the resulting classification was used as the gold standard. A total of 297 recordings were examined. Of these, 107 were consensus CFAE, 111 were non-CFAE, and 79 were equivocal or noninterpretable. FIs less than 120 ms identified CFAEs with sensitivity of 87% and specificity of 79%. ShEn, with optimal parameters using receiver-operator characteristic curves, resulted in a sensitivity of 87% and specificity of 81% in identifying CFAE. The K-S test resulted in an optimal sensitivi...Continue Reading

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Citations

Nov 17, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Charlotte L HaleyDamian P Redfearn
May 7, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Flavia Ravelli, Michela Masè
May 5, 2012·Journal of Cardiovascular Electrophysiology·Dennis H LauUlrich Schotten
Nov 23, 2010·Journal of Cardiovascular Electrophysiology·Atul VermaDavid J Wilber
Feb 4, 2011·Journal of Cardiovascular Electrophysiology·Milad El HaddadMattias Duytschaever
Feb 23, 2013·IEEE Transactions on Bio-medical Engineering·Nicolas NavoretStéphane Binczak
Aug 1, 2014·Progress in Biophysics and Molecular Biology·Flavia RavelliMarcello Disertori
Jun 28, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jason Ng, Jeffrey J Goldberger
Mar 6, 2015·Journal of the Royal Society, Interface·Hiroshi AshikagaJoshua Garland
Apr 20, 2017·Annals of Biomedical Engineering·Miguel Martínez-IniestaJosé J Rieta
Oct 21, 2016·Medical & Biological Engineering & Computing·Tiago P AlmeidaFernando S Schlindwein
Dec 25, 2012·Circulation. Arrhythmia and Electrophysiology·Anand N GanesanPrashanthan Sanders
Oct 15, 2019·Pacing and Clinical Electrophysiology : PACE·Jacques Mt de Bakker
Oct 10, 2015·Physiological Measurement·A Orozco-DuqueJ Bustamante

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